Is the periprostatic anesthetic blockade advantageous in ultrasound-guided prostate biopsy?

To assess the benefit of the periprostatic administration of lidocaine previously to ultrasound-guided prostate biopsy.

In the period from April to October 2002, forty patients underwent ultrasound-guided prostate biopsy due to increased PSA or abnormal digital rectal examination. A randomized double-blind study was performed, where the patients received an injection of lidocaine 2% or saline solution, in a total of 10 ml periprostatic. Immediately following the biopsy, the pain associated to the procedure was assessed, using a visual analogical scale from 0 to 10. The mean number of fragments collected per patient in the biopsies was 11.3. The statistical analysis used for assessment of pain was the Student's t, with p < 0.05 being significant.

The groups were homogeneous concerning the anthropometrical data. In relation to pain, those patients in the groups that underwent biopsy with the use of lidocaine presented a maximum score of 6, while in the group that underwent biopsy with the use of saline solution, 4 patients presented score 7 ou 8. The mean score and standard deviation with lidocaine were 2.55 +/- 2.34 (CI 95% = 1.53 to 3.57) and with saline solution were 3.75 +/- 2.52 (CI 95% = 2.66 +/- 4.84) with no statistical significant difference between the groups.

The lidocaine injection did not show statistical difference when compared with saline solution in the periprostatic blockade during echo-guided prostate biopsy.